Graduate Medical Education Strategy, Finance & Organization
Hospital involvement in graduate medical education (GME) is increasingly a focal point of many unique pressures. As new and existing SOMs across the U.S. enlarge the pipeline of students in response to projected physician shortages, the increase in graduating students creates pressure to develop new, or expand established, residency training programs.
Participation in GME is compelling. Residency training programs can synergistically advance key service line strategies, foster physician recruitment and workforce plans, and strengthen a hospital’s quality agenda. Yet the complexities of evolving accreditation requirements, limitations in federal reimbursement, and concerns regarding the impact of GME on operational efficiency and physician productivity confound GME participation decisions for teaching and historically nonteaching hospitals alike.
ECG has substantial experience assisting hospitals, SOMs, and faculty physician organizations in navigating the complexities of the GME enterprise. We ensure academic involvement complements clinical strategies, optimizes operational and financial performance, and furthers institutional goals and objectives. Our GME services include:
- GME strategic plan development.
- Interorganizational relationships and design of affiliation agreements.
- Program size and configuration planning.
- Financial and reimbursement analysis, management, and planning.
- Medical education office and program-specific operations improvement.
- Peer group comparisons and analyses.
Whether you are an existing or potential teaching hospital, or an SOM engaged with current or possible clinical partners, ECG can assist you in shaping your GME enterprise to provide a strong educational experience for your students, achieve financial expectations, represent a strategic asset that can be leveraged across the institution, and support your institution’s overarching objectives.
Selected Projects
Devising specific strategies and improvement plans across a multihospital system for four GME programs with approximately 100 residents. Expand Minimize
As a major component of an organization-wide strategic planning project, we devised a specific strategy to strengthen the private medical staff, positioning GME as an essential component of this objective. Our project resulted in actionable recommendations to expand and enhance the GME enterprise and to develop a new faculty model to foster opportunities for the private medical staff to participate in GME activities.
Assisting a large, independent AMC in devising a strategy for its academic enterprise including 35 GME programs with approximately 250 residents. Expand Minimize
ECG partnered with the client to: (1) define objectives for the AMC’s academic mission, (2) review the performance and financial impact of research and education programs, (3) establish recommended accountabilities and performance expectations for these activities, (4) develop a revised funds flow/physician compensation model for academic activities, and (5) modify the organizational structure for academic affairs. The result was a more contemporary and effective GME enterprise.
Providing interim management to the office of medical education for a 500-bed, community-based teaching hospital with nearly 150 residents and fellows. Expand Minimize
Our assistance during this 18-month project resulted in favorable accreditation results for several programs; improved processes and efficiencies; and enhanced service to residents, program directors, and faculty.
Engaging with a nonteaching hospital to analyze and evaluate Medicare reimbursement opportunities associated with establishing a desired set of GME programs. Expand Minimize
ECG assisted in defining a general strategy for the aggregate size and composition of a historically nonteaching hospital’s desired GME programs, preparing various implementation sequencing scenarios, projecting potential future Medicare reimbursement for the institution as a new teaching hospital, and identifying tactical implementation strategies that could be considered to appropriately optimize Medicare indirect and direct medical education reimbursement.
Assisting a large AMC in the development of a GME strategy and creation of a rational approach for adjusting the size and specialty composition of its GME programs within Medicare reimbursement caps. Expand Minimize
ECG developed financial, operational, academic, and mission-related criteria upon which to evaluate the appropriateness of individual GME programs. Furthermore, we devised a GME strategy and decision methodology that was sensitive to the impact of major external forces, including Medicare reimbursement changes, managed care penetration, and physician workforce planning issues. This process of exploring and identifying priorities relative to GME enabled the organization to define a GME strategy and clearly articulate a plan for periodic evaluation.
